感冒对住院精神障碍患者血浆奥氮平浓度的影响  

Effect of the common cold on plasma concentrations of olanzapine in patients with long-term hospitalized psychiatric disorders

作　　者：桑旭芳 马泊涛 齐思远 周波 安会梅[2] 杨甫德[2] SANG Xufang;MA Botao;QI Siyuan;ZHOU Bo;AN Huimei;YANG Fude(Basic Medical College of Inner Mongolia Medical University,Hohhot 010110,China;Peking University Huilongguan Clinical Medical School)

机构地区：[1]内蒙古医科大学基础医学院,呼和浩特010110 [2]北京大学回龙观临床医学院

出　　处：《中国健康心理学杂志》2024年第10期1447-1452,共6页China Journal of Health Psychology

基　　金：北京市科技计划首都临床诊疗技术研究及示范应用项目(编号:Z191100006619020);首都卫生发展科研专项(编号:CFH 2024-1-2131)。

摘　　要：目的:分析感冒对住院精神障碍患者血浆奥氮平浓度以及不良反应的影响。方法:采用回顾性研究方法,选取2020年2月至2022年9月就诊于北京回龙观医院服用奥氮平治疗且伴有感冒的86例精神障碍住院患者,从病历系统中提取患者的一般资料、实验室检查、感冒前和感冒期间奥氮平治疗药物监测数据、感冒期间用药和新增不良反应以及处置措施等信息。结果:①感冒期间血浆奥氮平浓度和剂量校正血浆浓度高于感冒前(t=-7.942,-8.763;P<0.01);②感冒期间血浆奥氮平浓度超过治疗参考范围上限(80ng/ml)的患者比例高于感冒前(χ^(2)=47.098,P<0.01);③血浆奥氮平浓度超过80ng/ml组的不良反应发生率高于血浆浓度低于80ng/ml组(χ^(2)=4.545,P<0.05)。结论:感冒期间精神障碍住院患者的血浆奥氮平浓度及不良反应发生率均明显升高。因此,当精神障碍患者发生感冒时,临床医生或药师应及时进行奥氮平的治疗药物监测,减少不良反应发生风险。Objective:To analyze the effects of colds on plasma olanzapine concentrations and adverse reactions in hospitalized patients with mental disorders.Methods:A retrospective study method was used to select 86 inpatients with mental disorders who attended Beijing Huilongguan Hospital for olanzapine treatment with colds from February 2020 to September 2022,and information on the patients'general data,laboratory tests,drug monitoring data of olanzapine treatment before and during colds,medication and new adverse reactions during colds,and dispositions were extracted from the medical record system.Results:①Plasma olanzapine concentrations and dose-corrected plasma concentrations were higher during the cold than before the cold(t=-7.942,-8.763;P<0.01);②The proportion of patients with plasma olanzapine concentrations exceeding the upper limit of the therapeutic reference range(80 ng/ml)was higher during the flu than before the flu(χ^(2)=47.098,P<0.01);③The incidence of adverse reactions in the group with plasma olanzapine concentrations exceeding 80 ng/ml was higher than that in the group with plasma concentrations below 80 ng/ml group(χ^(2)=4.545,P<0.05).Conclusion:Plasma olanzapine concentrations and the incidence of adverse reactions are significantly higher in hospitalized patients with mental disorders during a cold.Therefore,when patients with mental disorders experience a cold,clinicians or pharmacists should conduct timely therapeutic drug monitoring of olanzapine to reduce the risk of adverse reactions.

关 键 词：感冒 奥氮平 精神障碍 血浆浓度 

分 类 号：R749.05[医药卫生—神经病学与精神病学] R395.4[医药卫生—临床医学]